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Nutrition for Senior Citizens
Eating Right Is Worth the Effort for Health Aging
Making the effort to
eat right isn’t always a picnic for senior citizens
July 4, 2006 - Eating a nourishing diet is one of the top three
life habits that can protect health and delay disability -- and may be
more influential than genetics in helping older people stave off the
decline that can come with aging, according to the Centers for Disease
Control and Prevention. Making the effort to eat right isn’t always a
picnic for older adults, but the rewards are many.
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Yet, doctors often fail to screen older adults for
nutritional risk, says researcher Nancy Wellman. “Good nutrition and a
healthy diet is one of the most overlooked areas for healthy aging,”
says Wellman, director of the National Policy and Resource Center on
Nutrition and Aging. “Food is so basic, it’s often taken for granted.”
Physical and Psychosocial Barriers
Poor nutrition in old age can evoke images of a
frail pensioner prying open a can of cat food. But experts say in real
life, a constellation of physical, social and psychological problems can
keep older adults from eating well and enjoying food.
Certain medications can diminish appetite or
interfere with nutrient absorption, says Karen Zulkowski, a researcher
at Montana State University’s College of Nursing. Swallowing or dental
problems can also make seniors tentative about eating, she adds.
Even truly physical barriers can keep older people
from a good diet. “In an urban area, the grocery store can be right
across the street, but the elderly aren’t safe walking across the street
to get the food,” Zulkowski says.
Psychosocial concerns can also dampen appetite,
Wellman says. “Maybe their spouse has passed away, and they can’t
imagine sitting at the table looking at the empty chair.”
The Facts:
● Hypertension,
coronary heart disease and diabetes are all preventable, in part, by a
lifelong healthy diet.
● A 2004 study of
older Canadian adults found that the seniors with a poor diet had fewer
good physical health days and reported lower satisfaction with their
overall life.
● Poor health and
other barriers may prevent older adults from accessing food even when
they have money to purchase it, according to a 2001 Journal of
Gerontology study.
● Some medication side
effects can blunt appetite and impair digestion in older adults,
according to an Archives of Internal Medicine study.
● Persistent oral
health problems are linked with lower consumption of some foods and
nutrients, and dental health is closely linked with nutrition status
according to two Journal of American Dietetic Association studies.
● Frequency of social
contact is among the factors that can affect diet in older adults,
according to a 2005 Journal of Nutrition Health and Aging study.
● A small 2001 study
of healthy older people found that protein, carbohydrate and fat -- each
macronutrient working alone -- enhanced the seniors’ performance on
memory tests.
● Older women who
followed a low-fat diet were generally able to avoid weight gain over
seven years, according to January 2006 Women’s Health Initiative
results.
● Older women who
switched to a low-fat diet and ate more fruits and vegetables did not
have a significantly reduced risk for breast or colon cancer, according
to results of the 2006 Women’s Health Initiative.
● Postmenopausal women
who participated in intensive education sessions that encouraged them to
follow a low-fat, fruit-and-vegetable rich diet achieved only modest
reductions in cardiovascular disease risks over eight years.
● A study of nutrition
education strategies for older adults found few successful ways to
change behavior but suggests that the most effective approaches are
conducted in a social setting, while providing hands-on activities,
incentives and access to health professionals.
Nutritional Assessment
Provides a Map for Change
Uncovering the problems behind a poor diet or
altered eating pattern takes more time than is available in a routine
15-minute doctor’s visit.
“If you are really going to help someone with their
diet, you can’t just give them a tear-off sheet, or tell them to eat
more,” says Nancy Wellman, director of the National Policy and Resource
Center on Nutrition and Aging. “One needs to know where the gaps are in
one’s eating.”
Some experts call for nutritional risk assessment
for anyone over age 65, but Wellman says an analysis is especially
important for older people who have a chronic illness or multiple
chronic diseases. “The more complicated a person’s health profile is,
the more appropriate it is to make a referral to a dietitian,” she says.
Wellman says physicians rarely have the training or
time to suss out nutrition problems, but dietitians regularly “translate
the science of nutrition into the art of making healthier food choices.”
A nutritional assessment usually begins with a
simple questionnaire that can lead to a longer discussion about
lifestyle and food habits. That conversation can often uncover
motivation for change. “Sometimes they are willing to do almost anything
to stay out of nursing homes. If that means eating better and moving
more, it’s an easy sell,” Wellman says.
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Facts of Life - Published by the Health Behavior
News Service
Lisa Esposito, Editor
Taunya English, Science Writer
The Center for the Advancement of Health
identifies and disseminates state-of-the-science evidence about the
influence of behavioral, social and economic factors on disease and
well-being. Its purpose is to support health decision-making by the
public and strengthen relationships among researchers and policymakers.
The Center receives funding from a number of foundations, principally
The Annenberg Foundation, the John D. and Catherine T. MacArthur
Foundation and the W.K. Kellogg Foundation.
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Wellman’s team recently completed a ten-site study
designed to pinpoint simple steps to improve older Americans’ health.
Results aren’t published yet, but Wellman said, “We found that when we
offered mini-talks on nutrition and exercise, and used pedometers and
little food check-offs, it improved people’s self-reported health
status, and increased servings of fruits and vegetables, calcium-rich
foods and fiber.”
Susan Moores, a spokeswoman for the American
Dietetic Association, says crafting a successful meal strategy with
seniors requires both cheerleading and a velvet-glove approach.
“You will find that people in their 60s really do
not want necessarily to be grouped in with people in their 70s and
older,” she says. “And people in their 50s, certainly aren’t real
comfortable with the word ‘senior.’ So we have to be real careful with
how we talk with folks.”
Diet and nutrition needs can be very different
depending on a person’s age and level of independence, she adds. People
age 50 to 65 -- even up to age 75 -- may be primarily fighting obesity,
Moores says. The “young old” can be overweight and still undernourished
because they are not eating the right foods, she says. By contrast,
people over 75 have a greater risk for under-nutrition and for not
getting enough calories, Moores says.
In the United States, the largest healthy eating
program for seniors is the Older Americans Act Program, which provides
group dining and Meals on Wheels.
But Wellman says some older adults hesitate to ask
for help. Family members and health practitioners have to take cues from
older adults to know how much intervention is needed and welcomed,
Moores says.
Helping often begins with paying attention, she
says. “Be vigilant in watching. Is there an unexpected weight loss?
Check out the refrigerator; be a little snoopy,” Moores suggests.
Editor's Note: To easily check your Body
Mass Index (BMI) use
our handy table -
click here.
References
U.S. Department of Health and Human Services,
CDC, Coordinating Center for Health Promotion. (2006) “Healthy Aging,
Preventing Disease and Improving Quality of Life Among Older Americans.”
Centers for Disease Control and Prevention, Merck
Institute on Aging and Health. The State of Aging and Health in America
2004.
HH Keller et al. (2004) Nutritional risk predicts
quality of life in elderly community-living Canadians. J Gerontol A Biol
Sci Med Sci, Jan;59(1):68-74.
JS Lee et al. (2001) Factors Associated with Food
Insecurity Among U.S. Elderly Persons: Importance of Functional
Impairments. Journal of Gerontology: Social Sciences 56B(2): S94-S99.
DM Fick et al. (2003) Updating the Beers Criteria
for Potentially Inappropriate Medication Use in Older Adults. Archives
of Internal Medicine 163: 2716-24.
RL Bailey et al. (2004) Persistent Oral Health
Problems Associated With Comorbidity and Impaired Diet Quality in Older
Adults. Journal of the American Dietetic Association Oct.;104(10):1548.
NR Sahyoun et al. (2003) Nutritional status of
the older adult is associated with dentition status. Journal of the
American Dietetic Association. Jan;103(1):61-6.
NR Sahyoun et al. (2005) Dietary Quality and
Social Contact Among a Nationally Representative Sample of the Older
Adult Population in the United States. J Nutr Health Aging. 9(3):177-83.
RJ Kaplan et al. (2001) Dietary protein,
carbohydrate, and fat enhance memory performance in the healthy elderly.
Am J Clin Nutr, Nov;74(5):687-93.
BV Howard et al. (2006) Low-fat dietary pattern
and weight change over 7 years: the Women’s Health Initiative Dietary
Modification Trial. Journal of the American Medical Association, Jan
4:295(1):39-49
RL Prentice et al. (2006) Low-fat dietary pattern
and risk of invasive breast cancer: the Women’s Health Initiative
Randomized Controlled Dietary Modification Trial. Journal of the
American Medical Association, Feb 8:295(6):629-42.
SA Beresford et al. (2006) Low-fat dietary
pattern and risk of colorectal cancer: the Women’s Health Initiative
Randomized Controlled Dietary Modification Trial. Journal of the
American Medical Association, Feb 8:295(6):643-54.
BV Howard et al. (2006) Low-fat dietary pattern
and risk of cardiovascular disease: the Women’s Health Initiative
Randomized Controlled Dietary Modification Trial. Journal of the
American Medical Association, Feb 8:295(6):655-66.
NR Sahyoun et al. (2004) Evaluation of nutrition
education interventions for older adults: a proposed framework. Journal
of the American Dietetic Association, Jan;104(1): 58-69.
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